Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction

• Material Type: 博士論文
• Title: Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction
• Author/Editor: 乙宗, 佳奈子
• Author Heading: 乙宗, 佳奈子
• Publication Date: 2022-03-24
• Publication Date (W3CDTF): 2022-03-24
• Alternative Title: 異物による気道閉塞を原因とした院外心停止における病院前高度気道管理と神経学的転帰の関連性
• Degree grantor/type: 香川大学
• Date Granted: 2022-03-24
• Date Granted (W3CDTF): 2022-03-24
• Dissertation Number: 甲第804号
• Degree Type: 博士（医学）
• Conferring No. (Dissertation): 甲第804号
• Text Language Code: eng
• Alias of Author: Otomune, Kanako
• Subject Heading: Foreign body airway obstruction; Pre-hospital; Cardiac arrest; Airway management; Neurological outcome; OHCA
• Target Audience: 一般
• Note (General): Objectives: Several studies have examined the association between advanced airway management (AAM) and survival for arrest that is non-shockable, noncardiac in origin, or due to suffocation; however, the efficacy of prehospital AAM compared with no AAM following foreign body removal by emergency medical services (EMS) has not been examined. We aimed to compare neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA) due to foreign body airway obstruction (FBAO) managed with and without AAM after foreign body removal.; Methods: This retrospective observational cohort study used all emergency transportation data of Japan and the All-Japan Utstein Registry. We included patients with OHCA aged ≥18 years undergoing resuscitation and removal of airway foreign bodies by EMS from January 2015 to December 2017. The exposure of interest was prehospital AAM by EMS after foreign body removal, and the primary outcome was a favorable neurological outcome at hospital discharge (i.e., a cerebral performance category of 1-2).; Results: Overall, 329,098 adults had OHCAs and 23,060 had foreign bodies removed from their airways; 3681 adult patients met our eligibility criteria and were divided as: AAM (2045) and non-AAM (1636) groups. Propensity score matching resulted in 1210 matched pairs with balanced baseline characteristics between the groups. The rate of favorable neurological outcome was significantly lower in the AAM group than in the non-AAM group (OR 0.34, 95% CI 0.19-0.62). However, survival was not significantly different between the two groups (OR 1.08, 95% CI 0.84-1.37).; Conclusions: We have not demonstrated the benefit of AAM for patients with OHCA due to FBAO. Further study will be required to confirm the efficacy of AAM for those patients.
• DOI: info:doi/10.1016/j.resplu.2021.100140; https://doi.org/info:doi/10.1016/j.resplu.2021.100140
• Persistent ID (NDL): info:ndljp/pid/12263386; https://dl.ndl.go.jp/pid/12263386
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2022-05-09T11:57:37+09:00
• Date Created (W3CDTF): 2022-04-21
• Format (IMT): PDF
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): https://kagawa-u.repo.nii.ac.jp/records/9556
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp